Neurodevelopmental and Functional Outcomes of Extremely Low Birth Weight Infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993–1994
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- Betty R. Vohr
- From Women and Infants' Hospital, Providence, Rhode Island;
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- Linda L. Wright
- National Institute of Child Health and Human Development, Bethesda, Maryland;
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- Anna M. Dusick
- Indiana University, Indianapolis, Indiana;
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- Lisa Mele
- George Washington University Biostatistics Center, Rockville, Maryland;
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- Joel Verter
- George Washington University Biostatistics Center, Rockville, Maryland;
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- Jean J. Steichen
- University of Cincinnati, Cincinnati, Ohio;
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- Neal P. Simon
- Emory University, Atlanta, Georgia;
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- Dee C. Wilson
- Case Western Reserve, Cleveland, Ohio;
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- Sue Broyles
- University of Texas Southwestern Medical Center at Dallas, Dallas, Texas;
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- Charles R. Bauer
- University of Miami, Miami, Florida;
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- Virginia Delaney-Black
- Wayne State University, Detroit, Michigan;
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- Kimberly A. Yolton
- University of Tennessee at Memphis, Tennessee;
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- Barry E. Fleisher
- Stanford University, Stanford,California;
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- Lu-Ann Papile
- University of New Mexico, Albuquerque, New Mexico; and
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- Michael D. Kaplan
- Yale University, New Haven, Connecticut.
Abstract
<jats:sec><jats:title>Objectives.</jats:title><jats:p>The purposes of this study were to report the neurodevelopmental, neurosensory, and functional outcomes of 1151 extremely low birth weight (401–1000 g) survivors cared for in the 12 participating centers of the National Institute of Child Health and Human Development Neonatal Research Network, and to identify medical, social, and environmental factors associated with these outcomes.</jats:p></jats:sec><jats:sec><jats:title>Study Design.</jats:title><jats:p>A multicenter cohort study in which surviving extremely low birth weight infants born in 1993 and 1994 underwent neurodevelopmental, neurosensory, and functional assessment at 18 to 22 months' corrected age. Data regarding pregnancy and neonatal outcome were collected prospectively. Socioeconomic status and a detailed interim medical history were obtained at the time of the assessment. Logistic regression models were used to identify maternal and neonatal risk factors for poor neurodevelopmental outcome.</jats:p></jats:sec><jats:sec><jats:title>Results.</jats:title><jats:p>Of the 1480 infants alive at 18 months of age, 1151 (78%) were evaluated. Study characteristics included a mean birth weight of 796 ± 135 g, mean gestation (best obstetric dates) 26 ± 2 weeks, and 47% male. Birth weight distributions of infants included 15 infants at 401 to 500 g; 94 at 501 to 600 g; 208 at 601 to 700 g; 237 at 701 to 800 g; 290 at 801 to 900 g; and 307 at 901 to 1000 g. Twenty-five percent of the children had an abnormal neurologic examination, 37% had a Bayley II Mental Developmental Index <70, 29% had a Psychomotor Developmental Index <70, 9% had vision impairment, and 11% had hearing impairment. Neurologic, developmental, neurosensory, and functional morbidities increased with decreasing birth weight. Factors significantly associated with increased neurodevelopmental morbidity included chronic lung disease, grades 3 to 4 intraventricular hemorrhage/periventricular leukomalacia, steroids for chronic lung disease, necrotizing enterocolitis, and male gender. Factors significantly associated with decreased morbidity included increased birth weight, female gender, higher maternal education, and white race.</jats:p></jats:sec><jats:sec><jats:title>Conclusion.</jats:title><jats:p>ELBW infants are at significant risk of neurologic abnormalities, developmental delays, and functional delays at 18 to 22 months' corrected age.</jats:p></jats:sec>
Journal
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- Pediatrics
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Pediatrics 105 (6), 1216-1226, 2000-06-01
American Academy of Pediatrics (AAP)
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Details 詳細情報について
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- CRID
- 1360855571428647040
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- NII Article ID
- 30012914080
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- ISSN
- 10984275
- 00314005
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- Data Source
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- Crossref
- CiNii Articles